Regarding the March 7 Point of View “All the reasons for N.C. to expand Medicaid”: Dr. Robert Bilbro made his case for expanding Medicaid. While this may be a noble goal, it does not truly fix the problem.
Our delivery system needs reform, finely targeted reforms that address the real problems. Our problems are one part perverse economics and three parts poor health.
In the current system, providers are paid for delivering volume, not outcomes, and according to the recent N.C. Prevention Partners scorecard, North Carolina is sick, and it is costing us money and jobs.
Bilbro stated, “Episodic care through EDs is far more expensive and less effective than if the patient were established with a primary care medical home.” We must fix primary care first.
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Primary care is the best and most economical way to improve access to health care. Health care and health insurance are two separate things. For $600 a year we can have a medical home relationship that can provide nearly 75 percent of our health care needs. It’s a very simple structure: pay for care, then insure for risk.
The best medicine for our ills is a vibrant and diverse primary care practitioner base, where patients and providers are accountable to the same outcomes and improved health.